Agron Dragaj photojournalist | filmmaker

Whispers of the hungry

Malnutrition in Mauritania 

Year: 2011-2014 

Two billion people in the world suffer from various forms of malnutrition. Malnutrition is an underlying cause of death of 2.6 million children each year – a third of child deaths globally. 

Despite Mauritania's richness in its natural resources, with the fishing industry, iron ore, and gold deposits playing pivotal roles in the economic landscape, alongside the country's Atlantic coastline providing rich fishing grounds, malnutrition remains a critical challenge. It is exacerbated by recurring droughts, food insecurity, corruption and widespread poverty, impacting a significant portion of the population. This impact is particularly felt by children under five who suffer from stunting, wasting, and micronutrient deficiencies that hinder their growth and development. Additionally, the country's reliance on subsistence agriculture and pastoralism makes it vulnerable to climate change, further complicating efforts to ensure adequate nutrition. Governmental and international initiatives strive to improve food availability, diversify diets, and strengthen health systems to address acute and chronic malnutrition. This emphasises the need for sustainable solutions and community-based interventions to enhance resilience and long-term food security for all Mauritanians. 

  • A boy walks on the sand bank surrounding M\'Bera refugee camp. M'bera, Mauritania.Mauritania is the largest recipient of refugees fleeing the crisis in Mali. There are around 53,474 Malian refugees in M{quote}bera camp, 58 per cent of them children under 18.
  • UN humanitarian aid workers travel in military escorted convoys every day to reach M\'Bera refugee camp. Close proximity to the border with Malian restless region has prompted government of Mauritania to ensure safety of humanitarian workers working in Bassiknou area, by providing military escorts in Bassiknou  Mauritania.Mauritania is the largest recipient of refugees fleeing the crisis in Mali. There are around 53,474 Malian refugees in M\'bera camp, 58 per cent of them children under 18.
  • A boy walks past traditional houses in village Baghdad 2 in the outskirts of Guerrou, Mauritania.Female genital mutilation/cutting (FGM/C) refers to all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons. More than 130 million girls and women have experienced FGM/C in 29 countries in Africa and the Middle East where the practice is most common.Nearly 70 per cent of girls and women in Mauritania have undergone FGM with those living in rural areas and from poorer households more likely to experience the practice. FGM/C may cause severe pain and can result in prolonged bleeding, infection, infertility and even death.UNICEF and the government of Mauritania together with communities, NGO’s and other partners laid the path to fight to abandon this practice.In Mauritania, the multi-layered strategy to end FGM/C has been making progress.In 2008 a national strategy and action plan to abandon the practice was launched on the International Day of Zero Tolerance to Female Genital Mutilation. In 2011, in Nouakchott, religious leaders issued a fatwa forbidding FGM/C and emphasizing the dignity of human beings in Islam.  Local religious leaders took part in launching a regional fatwa with their peers in nine other African countries – Burkina Faso, Egypt, Gambia, Guinea, Guinea Bissau, Mali, Niger, Senegal and Sudan.
  • A mother sits on the bed of the intensive care unit  in CRENI,  a clinic for treatment of Severe Acute Malnutrition with complications in Aleg, Mauritania.Over 16,684 severely acute malnourished children were admitted and treated within 508 supported health facilities. 76 percent healed, and 0,5 percent of them died. There’s a decrease of 3.3 percent of global acute malnutrition.Mauritania is characterized by many opportunities, given its people’s potential and its natural resources. It is also characterized by various challenges in the areas of child survival, development and protection.The country continues to face a multidimensional crisis caused by food insecurity, a high rate of malnutrition, recurrent epidemics and an influx of refugees from northern Mali.These shocks have contributed to increased vulnerability, particularly among children and women. Today, more than one child in 10 dies before his fifth birthday.Through its main office in Nouakchott and a sub-office in Bassikounou, UNICEF Mauritania’s aims to reach all children, in every part of the country. UNICEF works with the Government, civil society and national and international organizations to make Mauritanian children’s right to survival, development and protection a reality.
  • A child's  mid-upper arm circumference (MUAC) is measured during the screening campaign on malnutrition in CRENAS centre, Tidjikja, Mauritania. The measurement of MUAC at this child reads severe malnutrition. She was immediately referred to further treatment.During the malnutrition screening children and their mothers undergo anthropometric measurements containing weight for height, upper arm circumference and general check up. Children who\'s anthropometric measurements fall under general recommendation are referred further for treatment as required. In the centre appetite test is performed for children who are screened as malnourished.UNICEF CRENAS centre is suited within maternity ward building in Tidjikja and it is managed by NGO AMAMI.
  • A community worker undertakes anthropometric measurements of the child during the child development session for mothers, a UNICEF programme implemented by its partner MASEF in Tidjikja, Mauritania.200 million children under five in the developing world are not fulfilling their potential for development. Because of poverty, under nutrition, micronutrient deficiencies, and learning environments that do not provide enough responsive stimulation and nurturance, children are developing more slowly, or failing to develop critical thinking and learning skills. This limitation in early development contributes to late school entry, poor school performance, and ultimately, limitations for success later in life.
  • Muhamed, 18 month old, anthropometric measurements showed that he is malnourished and will be issued with Ready to Eat Therapeutic Food  (RUTF) during the screening campaign on malnutrition in CRENAS centre, Tidjikja, Mauritania.Plumpy\'nut is a peanut-based paste for treatment of severe acute malnutrition and it removes the need for hospitalization, the 92 gram packets of this paste can be administered at home and allow larger numbers to be treated.During the malnutrition screening children and their mothers undergo anthropometric measurements containing weight for height, upper arm circumference and general check up. Children who\'s anthropometric measurements fall under general recommendation are referred further for treatment as required. In the centre appetite test is performed for children who are screened as malnourished.UNICEF CRENAS centre is suited within maternity ward building in Tidjikja and it is managed by NGO AMAMI.
  • A doctor prepares to check up the child at the CRENAM clinic. During the screening for malnutrition children are referred to the doctor for thorough medical examination in order to identify possible further complications that Severe Acute Malnutrition may have been caused by.   In the Mbera refugee camp, the Nutrition survey carried out in November 2014 showed a significant decrease of both global acute malnutrition (from 11.8 to 9.9%) and severe acute malnutrition (1.4% to 0.8) rates. As of today, UNICEF has been supporting the government nutrition center in the treatment of 444 severe acute malnutrition (SAM) cases and contributed to the treatment of 790 other SAM cases.
  • Doctor checks  a four year boy Mohamed Ag Mohamed, after being referred by health worker who screened Mohamed. The boy had indications of the Severe Acute Malnutrition with complications. After thorough check up the doctor concluded that Mohamed also suffers from respiratory infection and will be referred for clinical treatment of severe malnutrition and respiratory infection. In the Mbera refugee camp, the Nutrition survey carried out in November 2014 showed a significant decrease of both global acute malnutrition (from 11.8 to 9.9%) and severe acute malnutrition (1.4% to 0.8) rates. As of today, UNICEF has been supporting the government nutrition center in the treatment of 444 severe acute malnutrition (SAM) cases and contributed to the treatment of 790 other SAM cases.
  • A doctor prepares to check up the child at the CRENAM clinic. During the screening for malnutrition children are referred to the doctor for thorough medical examination in order to identify possible further complications that Severe Acute Malnutrition may have been caused by.   In the Mbera refugee camp, the Nutrition survey carried out in November 2014 showed a significant decrease of both global acute malnutrition (from 11.8 to 9.9%) and severe acute malnutrition (1.4% to 0.8) rates. As of today, UNICEF has been supporting the government nutrition center in the treatment of 444 severe acute malnutrition (SAM) cases and contributed to the treatment of 790 other SAM cases.
  • Mohammad Olud Barack 2 years old child with severe acute malnutrition, sits on the lap of his aunt at the intensive care unit of CRENI in Aleg.Mohammad was admitted to CRENI for treatment of severe acute malnutrition two days earlier.Over 16,684 severely acute malnourished children were admitted and treated within 508 supported health facilities. 76 percent healed, and 0,5 percent of them died. There’s a decrease of 3.3 percent of global acute malnutrition.Mauritania is characterized by many opportunities, given its people’s potential and its natural resources. It is also characterized by various challenges in the areas of child survival, development and protection.The country continues to face a multidimensional crisis caused by food insecurity, a high rate of malnutrition, recurrent epidemics and an influx of refugees from northern Mali.These shocks have contributed to increased vulnerability, particularly among children and women. Today, more than one child in 10 dies before his fifth birthday.Through its main office in Nouakchott and a sub-office in Bassikounou, UNICEF Mauritania’s aims to reach all children, in every part of the country. UNICEF works with the Government, civil society and national and international organizations to make Mauritanian children’s right to survival, development and protection a reality.
  • Mohammad Olud Barack 2 years old child with severe acute malnutrition, sits on the lap of his mother at the intensive care unit of CRENI in Aleg.Mohammad was admitted to CRENI for treatment of severe acute malnutrition two days earlier.
  • Abou Olud Mohammad, 22 months old child with severe malnutrition, As Abou was too weak to be able to take sufficient diet by mouth doctors had to insert a nasogastric tube.Abou was admitted to CRENI for treatment of severe acute malnutrition one week earlier and was diagnosed with severe acute malnutrition with complications, he had intestinal infection and diarrhea.
  • About Olud Mohammad, 22 months old child with severe malnutrition. Admitted to CRENI on 23.April.2015
  • Mohammad Olud Barack 2 years old child with severe acute malnutrition, sits on the lap of his mother at the intensive care unit of CRENI in Aleg.Mohammad was admitted to CRENI for treatment of severe acute malnutrition two days earlier.Over 16,684 severely acute malnourished children were admitted and treated within 508 supported health facilities. 76 percent healed, and 0,5 percent of them died. There’s a decrease of 3.3 percent of global acute malnutrition.Mauritania is characterized by many opportunities, given its people’s potential and its natural resources. It is also characterized by various challenges in the areas of child survival, development and protection.The country continues to face a multidimensional crisis caused by food insecurity, a high rate of malnutrition, recurrent epidemics and an influx of refugees from northern Mali.These shocks have contributed to increased vulnerability, particularly among children and women. Today, more than one child in 10 dies before his fifth birthday.
  • A 35 days old baby Lacuna, lays on the bed of the Medicines Sans Frontiers (MSF) clinic while attended by doctors in Mbera refugee camp.Lacuna was admitted to the clinical treatment of severe acute malnutrition and severe intestinal infection two days earlier. UNICEF in partnership with MSF In the Mbera refugee camp, the Nutrition survey carried out in November 2014 showed a significant decrease of both global acute malnutrition (from 11.8 to 9.9%) and severe acute malnutrition (1.4% to 0.8) rates. As of today, UNICEF has been supporting the government nutrition center in the treatment of 444 severe acute malnutrition (SAM) cases and contributed to the treatment of 790 other SAM cases.
  • A two years old Mohammad lays in his mothers arms on the bed of CRENI clinic where he was admitted for clinical treatment of severe acute malnutrition with medical complications. A nasogastric tube is used for feeding and administering drugs.Recovery ward in CRENI hosts clinically treated children for malnutrition with medical complications, who after initial five days are showing projected recovery. Usually children from this ward in few days are ready to be discharged and referred to Out Patient wards of CRENAM centre where they continue to be observed until full recovery.In the Mbera refugee camp, the Nutrition survey carried out in November 2014 showed a significant decrease of both global acute malnutrition (from 11.8 to 9.9%) and severe acute malnutrition (1.4% to 0.8) rates. As of today, UNICEF has been supporting the government nutrition center in the treatment of 444 severe acute malnutrition (SAM) cases and contributed to the treatment of 790 other SAM cases.
  • A child and his mother sit on the bed of the recovery ward in CRENI clinic managed by MSF (doctors without borders) in Mbera refugee camp.Recovery ward in CRENI hosts clinically treated children for malnutrition with medical complications, who after initial five days are showing projected recovery. Usually children from this ward in few days are ready to be discharged and referred to Out Patient wards of CRENAM centre where they continue to be observed until full recovery.In the Mbera refugee camp, the Nutrition survey carried out in November 2014 showed a significant decrease of both global acute malnutrition (from 11.8 to 9.9%) and severe acute malnutrition (1.4% to 0.8) rates. As of today, UNICEF has been supporting the government nutrition center in the treatment of 444 severe acute malnutrition (SAM) cases and contributed to the treatment of 790 other SAM cases.
  • Aberahmanne\'s mother feeds him a Plumpy Nut (RUTF) during the appetite test at CRENAS centre in Mbera camp. Aberahmanne was brought in for screening by his mother who said that he had a fever and diarrhea.Anthropometric Measurement indicated that he is severely malnourished. Subsequent to examination and anthropometric measurements, Aberahmanne was diagnosed with Severe Acute Malnutrition (SAM) and will need to undergo appetite test before he is referred further to CRENI for clinical treatment of malnutrition.In Mbera refugee camp, the Nutrition survey carried out in November 2014 showed a significant decrease of both global acute malnutrition (from 11.8 to 9.9%) and severe acute malnutrition (1.4% to 0.8) rates. As of today, UNICEF has been supporting the government nutrition center in the treatment of 444 severe acute malnutrition (SAM) cases and contributed to the treatment of 790 other SAM cases.
  • Community worker talks to Bredane and her nine months old child Dieda Mint Mustafa during the Nutritional screening and awareness raising session in Guerrou, Mauritania.This is the first time that Bredane attended Nutrition session.200 million children under five in the developing world are not fulfilling their potential for development. Because of poverty, under nutrition, micronutrient deficiencies, and learning environments that do not provide enough responsive stimulation and nurturance, children are developing more slowly, or failing to develop critical thinking and learning skills. This limitation in early development contributes to late school entry, poor school performance, and ultimately, limitations for success later in life.
  • Community worker refers nine months old child Dieda Mint Mustafa to CRENAS centre as measurement of Mid Upper Arm Circumference indicated that Died is malnourished. 200 million children under five in the developing world are not fulfilling their potential for development. Because of poverty, under nutrition, micronutrient deficiencies, and learning environments that do not provide enough responsive stimulation and nurturance, children are developing more slowly, or failing to develop critical thinking and learning skills. This limitation in early development contributes to late school entry, poor school performance, and ultimately, limitations for success later in life.
  • Laila Mint Mohamad Mahmoud and her ten months child Fatimetou, listen to community worker during the nutrition awareness session in Guerrou, Mauritania.Fatimetou’s malnutrition was discovered during the door-to-door awareness and screening sessions four months ago. Community workers referred Fatimetou at CRENI clinic for further treatment. Since then her recovery from malnutrition took positive turn. Her mother, Laila is thankful to the awareness and screening campaign to have discovered on time that her child was malnourished and was treated timely. After that Leila took all her five children to be checked for malnutrition. Ten months Fatimetou is regularly visited by community workers to ensure her complete recovery.200 million children under five in the developing world are not fulfilling their potential for development. Because of poverty, under nutrition, micronutrient deficiencies, and learning environments that do not provide enough responsive stimulation and nurturance, children are developing more slowly, or failing to develop critical thinking and learning skills. This limitation in early development contributes to late school entry, poor school performance, and ultimately, limitations for success later in life.
  • Bredane holds her nine months old child Dieda Mint Mustafa in her lap during the Nutritional screening and awareness raising session in Guerrou, Mauritania.This is the first time that Bredane attended Nutrition session. As the Midd Upper Arm Circumference indicated Dieda\'s malnourishment, she has been referred to the CRENAM clinic for further treatment.200 million children under five in the developing world are not fulfilling their potential for development. Because of poverty, under nutrition, micronutrient deficiencies, and learning environments that do not provide enough responsive stimulation and nurturance, children are developing more slowly, or failing to develop critical thinking and learning skills. This limitation in early development contributes to late school entry, poor school performance, and ultimately, limitations for success later in life.
  • Community worker of UNICEF\'s implementing partner MASEF, display various awareness material to mothers and their children about malnutrition and basic hygiene.During the malnutrition screening children and their mothers undergo anthropometric measurements containing weight for height, upper arm circumference and general check up. Children who\'s anthropometric measurements fall under general recommendation are referred further for treatment as required. In the centre appetite test is performed for children who are screened as malnourished.200 million children under five in the developing world are not fulfilling their potential for development. Because of poverty, under nutrition, micronutrient deficiencies, and learning environments that do not provide enough responsive stimulation and nurturance, children are developing more slowly, or failing to develop critical thinking and learning skills. This limitation in early development contributes to late school entry, poor school performance, and ultimately, limitations for success later in life.
  • A young boy holds a bag of Plumpy\'Nut,he received  during the malnutrition screening in CRENAS centre Tidjikja, Mauritania.During the malnutrition screening children and their mothers undergo anthropometric measurements containing weight for height, upper arm circumference and general check up. Children who\'s anthropometric measurements fall under general recommendation are referred further for treatment as required. In the centre appetite test is performed for children who are screened as malnourished.UNICEF CRENAS centre is suited within maternity ward building in Tidjikja and it is managed by NGO AMAMI.
  • preschool children attend child-friendly spaces, where they benefit from recreational activities and psychosocial support.
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